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Is the pediatric quality of life inventory valid for use in preschool children with refractive errors?
Ecosse L Lamoureux1, Manjula Marella, Benjamin Chang
1Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, University of Melbourne, Victoria, Australia. ecosse@unimelb.edu.au
Insights
The Pediatric Quality of Life Inventory (PedsQL 4.0) is not a valid tool for measuring how refractive errors affect health-related quality of life in preschool children in Singapore.
Area of Science:
- Ophthalmology
- Pediatric Health
- Psychometrics
Background:
- Refractive errors are common in preschool children.
- Assessing the impact of refractive errors on health-related quality of life (HRQoL) is crucial for early intervention.
- The Pediatric Quality of Life Inventory (PedsQL 4.0) is a widely used HRQoL scale.
Purpose of the Study:
- To determine the psychometric validity of the PedsQL 4.0.
- To assess its effectiveness in evaluating the impact of refractive errors on HRQoL in preschool children in Singapore.
Main Methods:
- Parents of 939 toddlers and 982 young children completed the PedsQL 4.0.
- Rasch analysis was employed to validate the PedsQL 4.0 scale.
- Data included refractive error status and visual acuity.
Main Results:
- Rasch analysis revealed disordered category thresholds and poor person-item targeting.
- Low separation reliability (0.00 for toddlers, 0.03 for young children) indicated no variance.
- The PedsQL 4.0 scores showed substantial multidimensionality, with variance explained <25%.
Conclusions:
- The PedsQL 4.0, in its current form, lacks psychometric validity for this population.
- The scale is not effective in evaluating the impact of refractive errors on HRQoL in Singaporean preschool children.
Purpose:
To determine the psychometric validity of the pediatric quality of life inventory (PedsQL 4.0) in assessing the impact of refractive errors on health-related quality of life (HRQoL) in preschool children in Singapore.
Methods:
Parents of toddlers (aged 25 to 48 months) and young children (49 to 72 months) completed the PedsQL 4.0, an HRQoL scale as part of population-based trial in Singapore. The outcome measures were the overall score, and the "physical"; "emotional"; "social"; and "school" functioning subscales. Rasch analysis was used to validate the PedsQL 4.0.
Results:
Parents of 939 (48.9%) toddlers and 982 (51.1%) young children completed the PedsQL 4.0 survey. The overall mean (±standard deviation) spherical equivalence for the right eye was 0.47 ± 1.13 diopter (D) for toddlers and 0.74 ± 1.22 D for young children. One hundred forty-nine (15.9%) toddlers and 90 (9.2%) young children were considered myopic (≥-0.50 D). Most participants (n = 1286, 89.6%) had presenting visual acuity 6/9 or better. Rasch analysis showed evidence of disordered category thresholds and poor person-item targeting for both groups. The separation reliability was 0.00 for toddlers and 0.03 for young children, indicating there was no variance in both samples. The PedsQL 4.0 overall and subscale scores displayed substantial multidimensionality as the variance values explained by the measures was <25% in both groups. A minimum value of 60% is usually considering acceptable.
Conclusions:
The PedsQL 4.0 in its current state is not a valid psychometric scale to effectively evaluate the impact of refractive errors on HRQoL in preschool children in Singapore.
